# PALMA FAMILY PRACTICE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649012972
- **Authorized official:** SANDY PALMA NP (OWNER)
- **Authorized official phone:** (773) 386-1861

## Contact information

- **Practice address:** 130 S BROADWAY ST STE B, BLACKFOOT, ID 83221-2711
- **Practice address phone:** (208) 242-7698
- **Mailing address:** 130 S BROADWAY ST STE B, BLACKFOOT, ID 83221-2711
- **Mailing address phone:** (208) 242-7698

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171400000X | Health & Wellness Coach | — | NULL | Yes |
| 171400000X | Health & Wellness Coach | — | — | Yes |

## Other

- **Enumeration date:** 06/07/2024
- **Last updated:** 06/07/2024